初次膝关节表面置换术近中期的疗效分析

Clinical study on outcomes of primary total knee arthroplasty

目的 评估初次膝关节表面置换术的早中期疗效,分析主要并发症发生的原因和预防方法 .方法 回顾分析自2000年1月～2007年12月,本组接受初次膝关节表面置换术的140例176膝,获得随访的患者129例160膝,平均随访时间为（35±8）个月（16～98个月）.术前和随访时对患膝进行KSS 和HSS评分,关节活动度检查,所得数据采用SPSS 17.0统计学软件进行统计学分析.结果 术后膝关节感染4例（2.5%）,其中2例为术后5～6年出现感染,与患者不恰当的局部注射治疗有关.膝关节关节僵硬（活动度小于75°）11例（（6.8%）,深静脉血栓形成1例（0.8%）,假体无菌性松动1例（0.6%）.随访时膝关节表面置换术后HSS及KSS评分均较术前显著提高,优良多达90%以上.膝关节活动度从术前的（87.7±27.7）°提高至术后的（108.8±21.9）°（t=2.272, P〈0.01）.结论 初次膝关节表面置换术对于消除膝关节疼痛,改善关节的活动功能效果明显,术后早中期的并发症发生率低.

Objective To evaluate the outcomes and complications of primary total knee arthroplasty. Methods A retrospective review was given to the date from 129 cases （160 knees） undergoing primary total knee arthroplasty between January 2000 and December 2007. The average follow-up time was （35 ±8） months. Each patient was assessed according to KSS and HSS. The range of knee joint motion was also evaluated. Results The infection rate after operation was 2.5% （4 cases）. The range of motion less than 75° occurred in 11 knees （6. 8% ）. The deep vein thrombosis was occurred at one patient and loosening of tibia prosthesis also occurred at one patient. The average of HSS was significantly increased from （39. 9 ±8. 0） preoperatively to （84. 1 ±12. 1 ） at follow -up（ t = 1. 087, P 〈 0. 01 ）. The average of KSS was also significantly increased at follow-up. The knee motion range was significantly improved from （ 87.7 ±27.7 ）° preoperatively to （ 108. 8 ± 21.9 ） ° during follow-up （ t = 2. 272, P 〈 0. 01 ）. Conclusions The TKA is an effective method to improve the function of the knee with end-stage arthritis.